Free USA Shipping

Vaginismus Causes

Physical and Non-Physical Sources

Vaginismus is unique because it may result from a combination of physical or non-physical causes, or seem to have none at all.

What Causes Vaginismus?

For many women, vaginismus comes as a surprise; unexplained tightness, discomfort, pain, and entry problems are unexpectedly experienced during intercourse attempts. The pain results from the tightening of the muscles around the vagina. Since this occurs without the conscious intent or control of the woman, it can be very perplexing.

 

Usually at the root of vaginismus is a combination of physical or non-physical triggers that alert the body to brace and protect. Additional sexual attempts that result in discomfort further reinforces the reflex response. When the body experiences increased pain, it reacts by bracing more on an ongoing basis, further entrenching this response and creating a vaginismus cycle of pain. Since vaginismus causes can be triggered by physical events as simple as having inadequate foreplay or lubrication, or non-physical emotions as simple as general anxiety, it is important that it be understood that vaginismus is not the woman’s fault.

 

Once triggered, the involuntary muscle tightness occurs without conscious direction; the woman has not intentionally “caused” or directed her body to tighten and cannot simply make it stop. Women with vaginismus may initially be sexually responsive and deeply desire to make love but over time this desire may diminish due to pain and feelings of failure and discouragement. It is extremely frustrating to be unable to physically engage in pleasurable sexual intercourse. The anticipation of pain, emotional anxieties, or unhealthy sexual messages can contribute to and reinforce the symptoms of vaginismus. Frequently, but not always, there are deep-seated underlying negative feelings of anxiety associated with vaginal penetration. Emotional triggers that result in vaginismus symptoms are not always readily apparent and require some exploration. It is important that effective treatment processes include addressing any emotional triggers so a full pain-free and pleasurable sexual relationship can be enjoyed upon resolution.

Vaginismus Cycle of Pain

The Internal Alarm

 

The limbic system sounds an internal alarm, alerting the body of potential pain. Once triggered, the body automatically tightens the vaginal muscles, bracing to protect itself from harm.

 

Sex then becomes uncomfortable or painful, and entry may be more difficult or impossible depending upon the severity if this tightened state.

 

Additional sexual attempts result in discomfort, further reinforcing the limbic system response so that it intensifies more.

 

Finally, the body experiences increased pain and reacts by bracing more on an ongoing basis, further entrenching this response and creating a vaginismus cycle of pain.

Vaginismus cycle of pain diagram, going through limbic systems, vaginal muscles, limbic reaction, and avoidance of intimacy.

Examples of Non-Physical Causes

Fear

Fear or anticipation of intercourse pain, fear of not being completely physically healed following pelvic trauma, fear of tissue damage (ie "being torn"), fear of getting pregnant, concern that a pelvic medical problem may reoccur, etc.

 

Anxiety and Stress

General anxiety, performance pressures, previous unpleasant sexual experiences, negativity

 

Partner Issues

Abuse, emotional detachment, fear of commitment, distrust, anxiety about being vulnerable, losing control, etc.  

Traumatic Events

Past emotional / sexual abuse, witness of violence or abuse, repressed memories

 

Childhood Experiences

Overly rigid parenting, unbalanced religious teaching (ie "Sex is BAD"), exposure to shocking sexual imagery, inadequate sex education

 

No Cause

Sometimes there is no identifiable cause (physical or non-physical)

Examples of Physical Causes

Medical Causes

Urinary tract infections or urination problems, yeast infections, sexually transmitted diseases, endometriosis, genital or pelvic tumors, cysts, cancer, vulvodynia / vestibulodynia, pelvic inflammatory disease, lichen, pains, lichen sclerosis, eczema, psoriasis, vaginal prolapse, etc.

 

Childbirth

Pain from normal or difficult vaginal deliveries and complications, c-sections, miscarriages, etc.

 

Age-Related Changes

Menopause and hormonal changes, vaginal dryness / inadequate lubrication, vaginal atrophy

Temporary Discomfort

Temporary pain or discomfort resulting from insufficient foreplay, inadequate vaginal lubrication, etc.

 

Pelvic Trauma

Any type of pelvic surgery, difficult pelvic examinations, or other pelvic trauma

 

Abuse

Physical attack, rape, sexual/physical abuse or assault

 

Medications

Side effects may cause pelvic pain

Did you know:

Vaginismus does not always have an obvious cause. Sometimes women with near perfect childhoods, great relationships, strong education, and few anxieties, have trouble finding any plausible explanation for what caused their vaginismus. Understanding why they had vaginismus may remain a mystery even after it is fully resolved. Fortunately, although it is helpful to know the causes, full knowledge is not necessary to complete successful treatment (see treatment kit).

Vaginismus is NOT the Woman's Fault

Since Vaginismus can be triggered by physical events as simple as having inadequate foreplay or lubrication, or non-physical emotions as simple as general anxiety, it is important that it be understood that vaginismus is not the woman's fault. Once triggered, the involuntary muscle tightness occurs without conscious direction; the woman has not intentionally 'caused' or directed her body to tighten and cannot simply make it stop. Women with vaginismus may initially be sexually responsive and deeply desire to make love but over time this desire may diminish due to pain and feelings of failure and discouragement. It is extremely frustrating to be unable to physically engage in pleasurable sexual intercourse.

Why do these causes trigger vaginismus in some women but not in others?

Life experiences vary dramatically from person to person. Some women's bodies react with vaginismus, while others with nearly identical experiences do not.

The anticipation of pain, emotional anxieties, or unhealthy sexual messages can contribute to and reinforce the symptoms of vaginismus. Frequently, but not always, there are deep-seated underlying negative feelings of anxiety associated with vaginal penetration. Emotional triggers that result in vaginismus symptoms are not always readily apparent and require some exploration. It is important that effective diagnosis and treatment processes include addressing any emotional triggers so a full pain-free and pleasurable sexual relationship can be enjoyed upon resolution.

Married couple hugging/leaning against each other overlooking picturesque lake and mountains

Vaginismus with Other Medical Conditions

Vaginismus is often a complicating factor in the recovery from other pelvic pain conditions. Vaginismus may co-exist with other medical conditions, possibly triggered by temporary pelvic pain resulting from those conditions. Or, it can be the sole cause of sexual pain remaining after the original medical problems are addressed. When the underlying cause has been resolved or managed and ongoing pain, discomfort or penetration difficulties continue to remain, this is typically due to vaginismus.

In cases where there is clearly both vaginismus and another pelvic medical problem existing simultaneously, both problems will need to be treated to ensure full resolution. Without addressing the other medical condition, it will be difficult to resolve the vaginismus as it may continue to be triggered by pain from the other problem.

Learn More: